Alpha-fetoprotein-producing advanced colorectal cancer: a rare case report and literature review

Abstract

Alpha-fetoprotein(AFP)-producing colorectal cancer is a rare form of colorectal cancer with a high degree of malignancy, advanced stage, strong invasiveness, poor response to treatment, rapid progression, and poor prognosis. Herein, we present the case of a middle-aged (in his 50s) male patient who underwent left neck lymph node biopsy due to "left neck lymph node enlargement for 5 months." Biopsy results revealed metastatic adenocarcinoma, and computed tomography examination of the chest and abdomen suggested a malignant tumor of the sigmoid colon with multiple metastases. Subsequently, the patient underwent colonoscopy, and the pathological result was colonic adenocarcinoma. Regarding tumor markers, serum alpha-fetoprotein (AFP) was 214 ng/mL. The patient received first- and second-line treatments for colon cancer, but progression-free survival was short. AFP was consistently elevated; after 8 months, the patient had AFP levels of 11,371.8 ng/mL, and imaging confirmed disease progression. The patient subsequently died, with an overall survival of more than 9 months. Compared with other tumor markers, AFP better reflects tumor progression in AFP-producing colorectal cancer.

Keywords: AFP-producing colorectal cancer; adenocarcinoma; metastasis; poor prognosis; serum AFP; tumor marker.

Figure 1.

Imaging dates of the primary sigmoid colon lesion and liver metastases. (a) At the time of diagnosis and (b) Eight months after diagnosis.

Figure 2.

Colonoscopy report. Irregular lumps can be seen. The surface is uneven; hyperemia, edema, and erosion are present, and bleeding occurs at a light touch.

Figure 3.

Biopsy findings. Common adenocarcinoma with low differentiation (hematoxylin and eosin staining, magnification 400×).

Figure 4.

Trends of tumor markers.